| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,623 |
1,622 |
$172K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
902 |
902 |
$115K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,976 |
1,967 |
$60K |
| 92015 |
Determination of refractive state |
2,454 |
2,452 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,222 |
1,216 |
$32K |
| V2020 |
Frames, purchases |
2,000 |
1,992 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
39 |
38 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,010 |
1,998 |
$0.00 |